Specialized Knowledge and Experience
for Treatment Providers

At this point, it should be fairly evident that providing treatment for adult
and juvenile sex offenders is in many ways a distinctive undertaking. Although
some aspects of sex offender treatment are similar to other types of treatment,
other components are quite different. Even experienced sex offender treatment
providers can find themselves challenged, perhaps most notably because of the
ever–evolving nature of the field. As noted previously, the models that
drive treatment for adult and juvenile sex offenders have changed considerably
over time, based on new research and theories about the individuals who commit
these offenses. Contemporary theories suggest that sex offending behaviors
among adults and juveniles are the result of a complex interaction of sociocultural,
biological, and psychological processes (see Ward, Polaschek, & Beech,
2006 for a review of theories). And as new research and theories emerge, the
field will continue to transform. To illustrate, treatment for adult and juvenile
sex offenders has been influenced in recent years by several key advances in
the field, including the following (see, e.g., Hanson & Morton–Bourgon,
2005; Hanson & Harris, 2000, 2001; Hunter et al., 2003, 2004a; Ward et
al., 2006; Worling & Langstrom, 2006):

Greater insights into the multiple and interacting influences believed
to be associated with the onset of sex offending behaviors among both adults
and juveniles;

Increased awareness of key dynamic risk factors which, if targeted effectively,
have the potential to reduce recidivism in the short and long term;

Greater appreciation for the differences between adult and juvenile sex
offenders, and the various implications for treatment and other management
approaches; and

The importance of process–related variables on treatment outcomes.

Taken together, these complexities underscore the need for specialized knowledge
and experience for those who intend to provide treatment for adult and juvenile
sex offenders (see, e.g., ATSA, 2005; Carter et al., 2004; English et al.,
1996). Obtaining that specialized knowledge and experience, however, is not
an easy endeavor. Ideally, practitioners who intend to work with adult sex
offenders should have specialized training and experience with forensic assessment,
forensic mental health or correctional psychology, involuntary clients, sex
offender management, group dynamics, and cognitive–behavioral therapy.
For those who plan to work with juvenile sex offenders, specialized knowledge
and experience should include juvenile justice, adolescent development, adolescent
mental health, family dynamics and family–based interventions, and sex
offender management, including a thorough understanding of the differences
between adult and juvenile sex offenders.

With few exceptions, graduate training programs do not typically offer focused
coursework pertaining to sex offender treatment. This leaves most interested
students without a specialized focus in this area. In some instances, graduate
students may have the benefit of a forensic specialization track through their
programs, which may allow them to gain valuable experience within criminal
or correctional psychology, juvenile justice, and other psycho–legal
settings. These types of experiences provide an important foundation for understanding
the interface between the mental health or psychology field and the court process,
criminal and juvenile justice systems, and forensic mental health environments.

Forensic rotations in field placements, practicum settings, and pre– and
post–doctoral internships provide a much greater likelihood of exposure
to the field, but even then, opportunities to work in an intensive environment
with the benefit of specialized clinical supervision and guidance may be limited.
It is often upon their actual entrance into the workforce following graduate
school that interested clinicians will have the greatest opportunities to become
fully immersed in the provision of sex offender treatment. Ironically, most
novice clinicians will have had relatively limited experience with sex offender
treatment at that point in time. Therefore, rigorous on–the–job
training, clinical oversight, and ongoing supervision are essential so that
these practitioners develop the necessary skills and competencies to provide
quality treatment for adult and juvenile sex offenders. Moreover, they must
always remain abreast of advancements in the research and practice literature,
and continuing education is critical.

In an attempt to promote consistency, specialization, and quality service
delivery, some states have created certification processes, statewide standards,
and policy–driven guidelines within agencies that establish minimum qualifications
for sex offender treatment providers. And some professional membership and
affiliate organizations have also established practice standards and guidelines
for their members (see, e.g., AACAP, 1999; ATSA, 2005; NAPN, 1993). Even with
standards and guidelines, rarely are there monitoring or oversight entities
to provide assurances that qualifications “on paper” translate
into quality service delivery. And in states where no standards or guidelines
have been promulgated, the variability in expertise is likely to be considerable.